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5th Metatarsal Break...or "simple" sprain???

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  #1  
Old 19th September 2008, 07:07 AM
Emily143 Emily143 is offline
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Unhappy 5th Metatarsal Break...or "simple" sprain???

(I'm in the UK, so am dealing with the NHS - which I normally have no complaints about. However...)

Four weeks ago I slipped and fell very suddenly on slippery ground. After about 40 minutes, my left foot had swollen to the point I couldn't walk on it. I had an x-ray that day and was told it wasn't broken, and to walk on it as pain allowed. I did that - barely walking on it and when I did, only gingerly - and it felt worse and the swelling got worse. My toes were all swollen and moved out of shape and the ball of my foot was swollen as well. One and a half weeks from the fall, I went to my GP and he said to stay off it completely, keep it raised, apply ice packs and continue taking the anti-inflammatory I'd been taking (at the highest strength/dosage possible) since the fall. (And continue with my pain meds..!) If it wasn't better in about 4-5 days, he told me to get another x-ray at A&E.

Two weeks + 1 day after the fall, I had another x-ray, and the A&E doctor told me my foot was in fact broken and I was fitted with a plaster of paris cast. I was given a follow up appointment for 2 weeks later and told to continue with the anti-inflammatories and keep the foot elevated at all times.

I went to the follow-up this past Tuesday and now I'm told it isn't broken, only sprained, and am scheduled for physio on Monday!!! When I questioned the A&E diagnosis, the "consultant" muttered something about junior doctors! He was abrupt and insulting - and didn't even know/acknowledge the facts of my injury. He wrote on my physio referral that it happened 2 weeks prior, not 4 weeks, i.e. the date of my visit to A&E, showing he didn't even read any notes/info from that date.

The swelling hasn't gone down at all since the day after the fall (the day of the fall it swelled up so much it didn't even look like a foot). The pain is exactly the same level, in the same localised places, and I still have a bruise running down the middle of the bottom of my foot. I can't stand on it without an incredible amount of pain - can't even hold it upright when sitting down with my leg stretched out. I get very sudden and sharp pains.

Should the swelling and pain be at exactly the same level 4 weeks on if it's a sprain? And if it is a sprain - an dthe pain and swelling are at the same level 4 weeks on - am I really ready for physio??

In the meantime, whilst the foot was in the cast, I developed a strange feeling around my big toe, like I'm wearing flipflops (with the thong between my big + next toe), as well as the feeling that there is a band around the base of the big toe. I overheard the "specialist consultant" I saw yesterday dictate in his notes that I had this pain (in the wrong foot!!!) and that he didn't know how to explain it - but no suggestion that we try to figure out what's causing it!

Also, they took the plaster cast off at Tuesday's appointment, and I now simply have a Tubi-grip around my (thinner!) calf, ankle and down to just short of my toes. The pad of my foot is swollen as well. My heel is beginning to alternate between actually hurting and going "numb". Wednesday the inside of my ankle started hurting and right now it is excruciating. My foot is swollen and the bruise on the bottom of my foot is still there, almost 5 weeks on. My foot is curving inward and I can't hold it in its "proper" position without a lot of effort and pain.

I'm out of work, in pain and scared that I've been misdiagnosed more than once. Daily, I'm on 150mg diclofenac sodium and up to 8 tablets of 30/500mg Solpadol (though I've been trying to keep it at 4 tablets because otherwise I get so sleepy I can barely think or speak). The diclofenac seems to be having no effect on the swelling/inflammation, and neither does keeping it elevated all day long.

I realise no one can make an actual diagnosis without seeing my foot and seeing the x-rays - though even those who have seen the x-rays seem unable to agree a diagnosis. I'm just in a lot of pain and very frustrated and looking for anything to help explain. Thanks to anyone who can help.

For what it's worth, I'm no wimp when it comes to pain. I can withstand quite a lot, and if I could be absolutely positive I wasn't doing any damage to my foot, I would be standing on it through the pain. But I can't help but think that the pain I'm having is trying to tell me something.
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Old 19th September 2008, 12:40 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

DISCLAIER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********

Clearly, no one without actually examining you can shed any meaningful light on your situation. The only "facts" to go on are totally unreliable, as you imply that your doctors don't seem to know what they are doing, and any decisions based on their suspect findings would be ridiculous. Worst of all, should you get any replies on what you actually have sustained or what might be done about it, they will be mere guesses on which you would likely be unwise to act. In conclusion, a competent examination by competent doctors is the only thing I can recommend. But, in light of your title to this post, you are very wrong if you think that even if it is a sprain that the word "simple" is appropriate, as sprains can be far more devastating than fractures and with sometimes permanent incapacities.

One further thought. It may be too early to consider post-traumatic sympathetic dystrophy, but discuss this with your doctors.
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Old 11th October 2008, 02:45 AM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

ugh.. I sort of understand your story
I sprained my foot at dance, and when I went to the doctor they told me it was broken. So I ended up with annoying crutches and an inability to walk.. etc

Anyway, when I went to an orthapedic surgeon for a followup a week later, he said that my foot was only sprained and that I could put weight on it as pain allowed..

That was a waste of a week of my life..

But your condition sounds more severe than mine. I only had swelling on the side of my foot
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Old 5th November 2008, 05:53 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

Have you found out any more information regarding your injury. My sister has the EXACT same problem right now, and she's really frustrated and we are too poor to keep going back to the doctor's.
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Old 10th November 2008, 02:54 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

In contrast to the original poster I fell down stairs and ended up at A&E, where the x-ray clearly shows the break to my 5th metatarsal. In cast until 16th December. The care I had there was excellent so it is a real shame you have no proper answers on your issue.

My bruising is different but perhaps this is due to it being the 5th bone, so on the edge of my foot. I'm hoping that as I immediately applied a cold tea-towel wrapped firmly and elevated immediately (didn't call anyone for at least 20 mins) that this helped with the initial swellilng.

I'm also sorry to hear the max dose of dicolefenac isn't working - I hope it clears up soon and you're back to walking again. Is there another hospital you could go to for a second opinion? Or a local chiropodist or podiatrist who could do a home visit and check you over?
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Old 14th November 2008, 04:06 AM
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Smile Re: 5th Metatarsal Break...or "simple" sprain???

Dear Emily, I am not a Doctor but I am an x-ray tech. In my experience. Sometimes it is harder for a sprain to heal than a Fracture. but Four weeks out you should see some improvement. I would recomend going to a Orthopedic Dr. They Specialize in this. Also if is a stress fracture on your fourth, and fifth metatarsal they can be hard to locate. They might order an MRI, to furthur diagnose you properly. Hope this helps Carrie lewis@wcrtc.net
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Old 18th November 2008, 03:40 AM
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Cool Re: 5th Metatarsal Break...or "simple" sprain???

i have sprain and i didn't go to the doctor but im not sure if its healed
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Old 4th December 2009, 06:39 AM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

I am not a doctor but I from what you've been telling me it sounds like you may have Reflex Sympathetic Dystrophy Syndrome (RSDS). My mother was diagnosed with this years ago and it took quite a few doctors until she found one who figured out what is wrong with her. I was doing some research on a foot injury I experienced myself recently and I came across your inquiry. From what I know of the disease it is permanent nerve damage and there is no cure. Like I said, I have no medical experience but from what I read of your story, it could be a possibility. Do some research on it and I find a doctor who has heard of this disease, good luck.
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Old 24th December 2009, 11:57 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

Foot Doc,
yesterday at gymnastics as I was doing a kip to the bar, there was a mat in the way and my toes kicked head on right into it. Hurts quite a bit if I walk properly (not veering to the medial side of my foot), is swollen and slightly discoloured on the top of my foot, on the lateral side. Painful at the top (4th metatarsal region i think?)with toe flexion and pointing, and walking normally feels swollen on bottom & top and hurts abit...but, i can jog if most of my weight is on my heels. Is this more likely to be a sprain or fracture, and since it seems pretty mild (I can walk and jog with varying my gait/stride/foot position) can I just treat it at home with ice or would i really have to get this checked?
Thanks so much
anje1973@hotmail.com
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Old 25th December 2009, 01:41 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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I would second the opinion of the x-ray tech that sprains CAN be more problematic in the long term than a fracture. Unfortunately, too often patients use the expression, "just a sprain," and consider that if there is not a fracture then there is no need for definitive care. So, whether or not you have sustained a fracture, you need at least an evaluation to determine the damage and appropriate care, especially as you will be routinely wanting to over-stress the foot in your normal activities as a gymnast and improper and/or non-timely treatment might haunt you in the future. I'm not sure why the tech who posted seemed to think that you were in your 4th week of discomfort, as you posted that this injury occurred yesterday. One thing for sure, though, although you might have sustained a micro-fracture through your explained trauma, you don't have what by would properly be termed a stress fracture, as by definition, a stress fracture is one sustained without a history of overt trauma. The bottom line is that unless you have this injury professional evaluated by either a podiatrist of an orthopedist, you will not know what you are dealing with in the necessary timely manner.
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Old 25th December 2009, 02:04 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

Sorry, but the portions of my post referencing a response by the x-ray tech which was actually a reply to someone else which I had mistaken thought was to your post.
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Old 15th May 2010, 09:26 PM
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Unhappy Re: 5th Metatarsal Break...or "simple" sprain???

foot doc i hurt my foot on thrusday and there was n swelling or bruising but it is now saturday and it hurts to walk on the one side(5th metatarsal) do you recomened me to treat it my self or go and get it checked out at the hospital
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Old 16th May 2010, 03:34 AM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

What I would recommend is that you go see a doctor to at least find out what you have done to yourself and then you can obtain from him/her an opinion based on substance as to whether you need professional care or can deal with it yourself.
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Old 16th May 2010, 08:52 PM
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Originally Posted by FootDoc View Post
What I would recommend is that you go see a doctor to at least find out what you have done to yourself and then you can obtain from him/her an opinion based on substance as to whether you need professional care or can deal with it yourself.
thanxs doc i will thankyou
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Old 18th June 2010, 12:24 AM
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Question Re: 5th Metatarsal Break...or "simple" sprain???

I rolled my foot about 4.5 weeks ago and went to DPM after 1 week since I thought it was a sprain. After two weeks in a soft cast and walking boot, I had an MRI which revealed a fracture of the distal metadiaphysis of the 5th metatarsal with marrow edema throughout much of the diphysis and distal metaphysis. There is slight varus angulation. I'm now in just an ace bandage in walking boot and told no exercise, jumping and minimal walking, ice as needed, etc. for 4-6 weeks.

Can you explain foot doctor in English what the radiologist report means? I thought 5 metatarsals were Jones or anvular?

Thanks!
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Old 18th June 2010, 02:20 AM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

Without burdening you with the anatomical definitions of diaphysis, metaphysis and metadiaphysis, which would likely not really add to your basic understanding, suffice it to say that your fracture, according to the report, is located in the distal (furthest away from the heel) portion of the 5th metatarsal shaft but not as far as the distal end (head) of the bone, which is located near the 5th toe. Both Jones fracture and avulsion fractures of the styloid process of the 5th metatarsal are at the other (proximal) end of the bone. The most potentially problematic would be the Jones due to the typically relatively poor vascularization of that area. Marrow edema would be swelling and fluid in the bone marrow canal.
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Last edited by FootDoc; 18th June 2010 at 02:22 AM.
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Old 20th June 2010, 05:03 AM
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Question Re: 5th Metatarsal Break...or "simple" sprain???

Quote:
Originally Posted by FootDoc View Post
Without burdening you with the anatomical definitions of diaphysis, metaphysis and metadiaphysis, which would likely not really add to your basic understanding, suffice it to say that your fracture, according to the report, is located in the distal (furthest away from the heel) portion of the 5th metatarsal shaft but not as far as the distal end (head) of the bone, which is located near the 5th toe. Both Jones fracture and avulsion fractures of the styloid process of the 5th metatarsal are at the other (proximal) end of the bone. The most potentially problematic would be the Jones due to the typically relatively poor vascularization of that area. Marrow edema would be swelling and fluid in the bone marrow canal.
Foot Doc: thanks for the clearer explanation. I'm going back to the DPM on Tuesday and that will be 4 weeks I have been in the boot and 2 weeks without soft cast. I am now in ace bandage. Dumb question, but can a fracture of the 5th metatarsal be neither Jones nor avulsion? I think that is what you are saying if it was a Jones it would be a the other end of the metatarsal bone from where my fracture is. I've been told that recovery time is about 4-6 weeks and I'm nearly through 2 weeks from the definitive diagnosis from the MRI. The injury occured 5 weeks ago. First week I thought it was a twist/sprain/strain but after the realized it should have felt better after a week and then I went to DPM. Wore soft cast and walking boot for first 2 weeks. Have been in ace bandage and walking boot for last 2 weeks. Hoping that possibly I can try putting some weight on my foot this week, but not counting on it. Foot has been feeling stiff. Is this normal?
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Old 20th June 2010, 12:11 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *
A Jones fracture is a fracture at a specifically defined location on the 5th metatarsal. That location happens to naturally have less circulation than other areas of that bone, and thus is subject to poor healing. An avulsion fracture is one in which a segment of the bone is pulled away from the main body by trauma forces acting on a tendon or ligament which inserts into that portion. Typically, that area on the 5th metatarsal is the styloid process at the base of the bone. In general, most fractures of a metatarsal other than the Jones fracture normally heal in about 6 weeks in the healthy patient in which the fracture has been properly stabilized. Whether that sort of stabilization requires a hard cast, a soft cast or none at all, and whether weight-bearing is allowed in the more readily healed fractures is up to the attending doctor. A Jones fracture, because it is problematic, almost always, if not always, requires casting and non-weight-bearing for a time. A feeling of stiffness is generally associated with troubled movement at a joint, so I am not sure what you are relating. Certainly discomfort at the site of a fracture would be normal, as would be initial joint stiffness in the area after an extended period of immobilization.
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Old 5th July 2010, 08:16 AM
49Yr old 5th true Jones
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Default Re: 5th Metatarsal Break...or "simple" sprain???

Hello Doc,
Broke my 5th Metatarsal May 17th...Didn't hear any cracking sound like I did on my left foot 30+ yrs ago, thought I sprained my ankle, kind of ignored it, walked on the inside edge of my foot, it was really tender though. After 11 days, wife pushing, I went to ER and Xrays, and Orthopedic surgeon, and true Jones is me! Was offered surgery, as it doesn't heal in most cases, but took my chance on self healing! So, cast, come back in 3 weeks, we'll take some Xrays and see if it's healing. Need to say that the break is clean, throughout, perhaps 1 to 1.5 mm gap at the most. 3 weeks gone by, Xrays, and "it looks like you have 80% chance of not needing surgery!" coming from US surgeon, that's a statement. But he removes the cast, and puts me in the boot (The French years ago didn't do that, but it's true that I was much younger, and it wasn't a true Jones). He also "touched" my foot in a "pressing" way I didn't like at all almost pulling of sorts? But anyways, I thought I was doing good, until two weeks later when a new set of Xray were to be taken, and now I am not healing, actually I thought the Xrays were switched or something, it still shows a 1mm gap or so, and pretty much no bone growth? It's like my body ate the bone growth that was there last time. I mean it wasn't nearly as opaque as bone, but now it's surely all gone. So I do need the surgery according to my Orthopedic surgeon. Now once I get the hollow screw (that's a big darn screw), what is guarantying me that proper bone growth will occur now that the little blood supply that was there has been totally disrupted by the drilling, screwing, etc...How do I know that there will not be any rotation of the bones pieces in relation to each other when he inserts the screw, or that they'll be spread apart even further? How long is it going to take before I can put some weight on that foot (I have been using crutches for the past 5+ weeks). Is that bone stimulating medicine a good thing, he hasn't mentioned anything about that. Is there a risk that it will stimulate the weird bone growth I already have in my mouth (bumps) in the gum below some of my teeth? Will I have permanent pain, or weakness with the screw? What is the typical recovery time after the surgery? Cast? or boot? How is the pain, for how long? He wants to do general anesthesia? Is that warranted in my case?
Can I ask for local? Would that be stupid? Will I ever be 100% again? Well, that's a lot of questions, but should you answer them all, that will stand as a pretty decent article for future reference. Thanks. Cheers
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Old 5th July 2010, 01:42 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

Quote:
Originally Posted by 49Yr old 5th true Jones View Post
Hello Doc,
what is guarantying me that proper bone growth will occur now that the little blood supply that was there has been totally disrupted by the drilling, screwing, etc...How do I know that there will not be any rotation of the bones pieces in relation to each other when he inserts the screw, or that they'll be spread apart even further?
There are no guarantees in medicine, but this is a routinely performed procedure, and assuming that your surgeon is competent, I would let him be the judge of the prognosis.


Quote:
Originally Posted by 49Yr old 5th true Jones View Post
How long is it going to take before I can put some weight on that foot
Generally a number of weeks, but I do not know what your doctor's protocol is, and I would not substitute mine for his. Why have you not asked this question to the person who will decide (your surgeon)?

Quote:
Originally Posted by 49Yr old 5th true Jones View Post
Is that bone stimulating medicine a good thing, he hasn't mentioned anything about that.
What medication are you talking about, and if he hasn't mentioned it, what makes your think anything will be prescribed?

Quote:
Originally Posted by 49Yr old 5th true Jones View Post
What is the typical recovery time after the surgery? Cast? or boot? How is the pain, for how long?
Typical in my or in other doctors' hands is a useless fact. What matters is what is typical in your own doctor's hands. ASK HIM.

Quote:
Originally Posted by 49Yr old 5th true Jones View Post
He wants to do general anesthesia? Is that warranted in my case? Can I ask for local? Would that be stupid?
I would generally perform such surgery under local anesthesia, but not all surgeons are competent in achieving adequate local blocks and/or are comfortable performing surgery under local anesthesia. Certainly, you can ask, and no, it would not be stupid to do so. In my opinion, as this sort of surgery is generally performed as an out-patient procedure in the U.S,, the last thing I want is a patient leaving the hospital on crutches and being still a little groggy from the anesthesia. Most routine surgery on the foot can be performed quite nicely under local anesthesia if the surgeon knows how.


Quote:
Originally Posted by 49Yr old 5th true Jones View Post
Will I ever be 100% again?
Probably, if all goes well. But I have no crystal ball. Again, this is an assessment which can more appropriately made by your own doctor
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Old 6th July 2010, 11:11 PM
49Yr old 5th true Jones
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Default Re: 5th Metatarsal Break...or "simple" sprain???

With regards to the bone growth medicine, I read it somewhere on this Forum. But I wasn't able to find it on this thread, perhaps another thread? I was surprised myself...that's why I asked the question.
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Old 6th July 2010, 11:24 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

With regards to the local anesthesia: how is that performed exactly? Sedation, how, what, where? Anything else I should know about local anesthesia in my case? Should I find someone that IS knowledgeable with local anesthesia, or should I just follow his guidance, and go for it?

He seems to think that I am not going to heal. That's after 6 weeks since the incident. Does True Jones fracture if left immobilized will ultimately heal? Considering there has been no bone rotation, that it is a clean break, and that the gap is only 1.5 mm at most what are my chances to be healed within 4 weeks, 8 weeks? Is the healing typically slowing down more and more as time goes by? What did they do 200 years ago? A human's got to heal bones somehow even if it's going to take a while, no? I am just trying to get a "second opinion" here, as he seems a bit surgery happy perhaps? From the purely human reconstruction elegance stand point, I just don't understand how I am going to heal any better with most blood marrow gone, a whole bunch of blood vessels destroyed, etc...? Unless, once the screw is in there I am say 95% overnight? What if the screw is slightly bigger than the inner diameter of the bone, ever so slightly that it cracks the bone lengthwise and weakens it? Then one would not be 95% repaired overnight, would he?
What is your experience with this kind of surgery? What should I expect? He says he has performed just a few, like 20 to 30 in his career? Your thoughts please.
Thanks
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Old 7th July 2010, 01:18 AM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

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Local anesthesia is effected by either a nerve block or by infiltration into the area of the surgery or sometimes both. Sedation is employed at the discretion of the surgeon or as per the wishes of the patient. I am very comfortable using local anesthesia and am confident in achieving a block which will allow me to perform the surgery while affording the patient comfort and absence of pain. In most cases I do not employ sedation, as I have achieved the confidence of the patient and once the patient sees that he/she will not have pain, both of us enjoy being able to talk with each other during the procedure. I have had to convert to general anesthesia during a procedure only once in my long career, and that was due to an inordinate intra-operative rise in blood pressure.

Due to the natural relative sparsity in circulation in the area of a Jones fracture, it is difficult to predict with assurance when total healing will take place, however statistically the fracture heals quicker and better with internal fixation. I'm sure that a competent surgeon will select a screw of the proper size and place it properly. I don't have any idea of what you mean by "95% overnight." The person whom you should be asking what you should expect is the doctor who is to perform the surgery. It is HIS experience that matters, not mine. I would think that if has performed 20 or 30 such surgery that he has sufficient experience at it and can give you a good idea of what to expect in his hands.
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Last edited by FootDoc; 7th July 2010 at 01:20 AM.
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Old 21st July 2010, 02:27 PM
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Exclamation Re: 5th Metatarsal Break...or "simple" sprain???

I Broke i think it was 3 of the metatarsals in my right foot about 3 months ago. Now just yesterday I managed to fall (Skateboarding) and twist the same foot again, It isnt as swollen but it does hurt, i can walk and bend my toes up and down, although bending them down is painless however when bending my toes up it begins to hurt the further i go, but i can still manage. I have a feeling I re-fractured either one or two of my metatarsals, however again its not as bad as it was the first time I did it, could it be a sprain or bad tweak of any kind? thanks.
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Old 21st July 2010, 03:07 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

You've already stated that you think you broke a couple of bones and that you've had the experiencing of breaking them before. So I would think that the only way you will know for sure is by seeing a doctor for an evaluation and x-rays. What it COULD be is not going to be helpful toward that end.
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Old 1st November 2010, 05:57 PM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

thanks I am on my way to the ortho doctor shortly and going to try to get some clarification further on jones fracture and avulsion fracture. I was told at Urgenr care had avulsion fracture splinted and ortho put me in a cast for 3 weeks. Ortho looked at X rays told me I had a mess I did not know what questions to ask. Ortho took me out of cast gave me an air cast (pointless) later got a walking boot hard to put all weight down and lots of swelling on the top of the foot had MRI done think it was of the foot only and from what I have been reading may need MRI of the ankle. injury happenned Sept 18th rolled right foot complete 360 when fell into a ditch. I need some answers and pain relief after this appointment may get s second opionion guess first thing I need to do is ask good questions and find out what exactly I had he took me out of cast after 3 weeks because I developed cast foot and could not feel my 3 little toes.
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Old 7th June 2013, 02:03 AM
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Default Re: 5th Metatarsal Break...or "simple" sprain???

Foot doc,
A year and a half ago I fell while wearing heels and my little toe was bent the wrong way. The following morning my toe was red, swollen and painful. I thought it was a small sprain and so I left it, without going to the doctor, and now 18 months on little has changed. It is chronically slightly bigger than the 5th toe on the opposite foot and is always red. It is extremely painful when I am walking on uneven surfaces or up or down hills. It is made significantly worse if I wear shoes that are too tight or heels, so I avoid them. There is a bony lump around the 5th MTP joint that is quite painful, and now the 4th metatarsel is beginning to get quite painful. Would you say it is a sprain or a fracture that never healed? I only had minimal swelling at the time of injury so I did not think it was a fracture.
Thank you
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